CCG Series: CCG Assurance framework explained

Dr Nadim Fazlani, co-chair of the NHS England group tasked with developing the CCG Assurance Framework and clinical chair of Liverpool CCG lays out exactly how CCGs could benefit from a new framework

The Beveridge Report was published in 1942. One of the three guiding principles was that learning from experience should not be constrained by sectional interests and that it was time for revolution – not for patching. 

We have had the Francis Report and now the Keogh Report clearly showing that though the NHS delivers most of the time there are also places with unacceptable standards of care. 

CCGs working with partners will have to deliver on change. To do this requires the CCGs and the local health economy to support the ambition. The CCGs must aim to be the best they can be, not just good enough. 

The CCG Assurance Framework aims to support that ambition. Co-chaired by myself and the NHS England director of CCG development John Bewick, with input from areas across England, as well as local authorities and patient representatives, we aim to create national standards which could be locally responsive. 

It would be fair to say that at this moment in time it’s a work in progress. I’ve seen the draft outline of the Assurance Framework and some CCGs have been involved in the dry run, with area teams using the draft CCG Checkpoint Dashboard. 

It’s clunky but we will have time over the summer to make changes to reflect feedback from CCGs as well as NHS England. 

The CCG Assurance Framework is not meant to be world-class commissioning or even an authorisation framework in another form. Five regional events and a national event have been held to ask for views from CCGs and NHS England. It is clear – although this had not been the intention – that there will be an end of year version of the authorisation process. 

The authorisation process was to assess the readiness of CCGs to become a statutory body. But the purpose of the authorisation framework is to support the development of CCGs and also to address the developmental needs of NHS England. 

Of course NHS England and CCGs are statutory bodies, but area teams on their own are not. This does create an issue in terms of assurance, as NHS England is responsible for delivering the mandate which by its nature should be high level and strategic. However, it’s clear that transformational change is not going to be delivered unless all commissioners are supported in their development.

The challenge for the future will be that the Assurance Framework should support the development of all the commissioners but should not become process focused while clearly providing assurance. But the best way of doing it is to aim high so that we surpass the minimum standards.